Psychological consequences of having triplets: a 4-year follow-up study.

OBJECTIVE: To assess the mental health of mothers of triplets and the quality of relationship with the children 4 years after delivery. DESIGN: Prospective follow-up study from delivery, to 4 years. Assessments at home by a psychologist, using semistructured tape-recorded interviews. SETTING: One maternity hospital in Paris, France. PATIENT(S): Eleven consecutive mothers having delivered triplets between October 1988 and February 1990. All except one had conceived after infertility treatment. MAIN OUTCOME MEASURE(S): Evaluation of the mothers' emotional well-being and level of depression measured by the CES-D Scale (Center for Epidemiologic Studies-Depression Scale). Opinion of the mothers about the quality of the relationship with the children. RESULT(S): All mothers reported emotional distress at 4 years, mainly fatigue and stress. Four mothers had a high score of depression and used psychotropic medication. The relationship with the children and difficulties in coping with their aggressive behavior and conflicts were the main reason for psychological distress. Difficulties had not decreased since the previous assessment at 2 years. Four mothers spontaneously expressed regrets about having triplets. CONCLUSION(S): Patients undergoing infertility treatments should receive adequate information about the long-term psychological "cost" of a triplet birth. Infertility treatments should be adapted in order to decrease the risk of triplet pregnancies.